What Is Custodial Care?

Custodial care includes helping with activities of daily life like eating. Image © SelectStock/GettyImages

Custodial care is care that doesn’t require the specialized skills of a licensed health care professional to perform. It doesn’t require advanced medical assessment skills, technical skills, or medical decision-making skills. Rather than on helping you recover from an illness or injury, custodial care is care focused on your activities of daily living, or ADLs, such as hygiene, dressing, and eating.

Laypeople can perform custodial care tasks either without any training, or with minimal training. Examples of custodial caregivers include family members and hired caregivers such as home health aides, companions, and sitters.

Examples of Custodial Care

The aide in your assisted living facility positions a shower chair in the shower. You’re unsteady on your feet, so he helps you walk to the shower and sit in the shower chair. He assists you with showering, shampooing, and shaving. He then helps you get out of the shower, dry off, comb your hair, and brush your teeth. He helps you get dressed and ties your shoes since you’re unable to reach them yourself.

For several years, you’ve been a paraplegic with a colostomy due to a gunshot wound to your abdomen. You’ve just had carpal tunnel surgery and your right wrist is in a splint. While you’re recovering from your carpal tunnel surgery, you can’t use your right hand to care for your colostomy or to help you move between your wheelchair and your bed.

Your wife provides custodial care by assisting you with transferring between your wheel chair and your bed. She empties and cleans your colostomy bag for you.

You’ve become frail, forgetful, and have trouble completing multistep tasks. A hired companion drives you to the grocery store. She helps you safely walk across the parking lot and into the store.

She helps you select groceries, reminding you that you also need to buy toilet paper and cat food. She helps you check out, making sure that you give the cashier the correct amount of money and receive the correct amount of change. She loads your groceries in the car.

Once you’re back home, she helps you get safely back up your front steps and into your home. She brings the groceries in from the car and puts them away. She makes you a tuna sandwich, serves it, and reminds you that it’s time to take your lunch-time pills. She washes the dishes, and puts them away.

Where Custodial Care Takes Place

Custodial care can take place in your home, an assisted living facility, a board and care home, a residential care center, an intermediate care facility, and many other places. It’s the nature of the care involved, not where the care takes place, that defines care as custodial care.

Custodial Care Vs Skilled Care

Care that requires advanced medical assessment skills, technical skills, or medical decision-making skills beyond those a layperson with minimal training could provide is considered skilled care rather than custodial care.

Skilled care requires the skills and training of a licensed health care professional; custodial care does not.

While medically necessary skilled care is sometimes covered by health insurance, custodial care usually isn’t covered by health insurance. Custodial care may be covered by long-term care insurance, but much of it is provided without charge by family members and loved ones.

See also “Home Health Care & Health Insurance—Understanding Your Coverage.”

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